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- Association of sleep traits with myopia in children and adolescents: a meta-analysis and Mendelian randomization studyPublication . Dong, Xing-Xuan; Xie, Jia-Yu; Li, Dan-Lin; Dong, Yi; Zhang, Xiao-Feng; Lança, Carla; Grzybowski, Andrzej; Pan, Chen-WeiPurpose: The association between sleep and myopia in children and adolescents has been reported, yet it remains controversial and inconclusive. This study aimed to investigate the influence of different sleep traits on the risk of myopia using meta-analytical and Mendelian randomization (MR) techniques. Methods: The literature search was performed on August 31, 2023, based on PubMed, Embase, Web of Science, and Cochrane Library. A meta-analysis of observational studies reporting the relationship between sleep and myopia was conducted. MR analyses were carried out to assess the causal impact of genetic pre-disposition for sleep traits on myopia. Results: The results of the meta-analysis indicated a significant association between the risk of myopia and both short sleep duration [odds ratio (OR) = 1.23, 95% confidence interval (CI) = 1.08-1.42, P = 0.003] and long sleep duration (OR = 0.75, 95% CI = 0.66-0.86, P < 0.001). MR analyses revealed no significant causal associations of genetically determined sleep traits with myopia, including chronotype, sleep duration, short sleep duration, and long sleep duration (all P > 0.05). Conclusions: No evidence was found to support a causal relationship between sleep traits and myopia. While sleep may not independently predict the risk of myopia, the potential impact of sleep on the occurrence and development of myopia cannot be disregarded.
- Anti-myopia spectacles: the standard of care in the future?Publication . Lança, Carla; Pan, Chen-Wei; Grzybowski, AndrzejReports of myopia increases across the world show an expanding growing public health problem. Myopia prevalence is exceptionally high in some continents, especially in Asia and particularly east Asian countries, but was also reported to have increased in other continents, such as North America and Europe, although there is considerable variation between geographic areas and racial groups in the myopia burden. The presence of myopia, especially high myopia, increases the risk of development of pathologic myopia and visual impairment. The peak incidence of myopia occurs in childhood, but the associated blinding ocular complications develop later during adulthood. Children with an increased risk of visual impairment due to pathologic myopia often have a longer duration of the disease, longer axial length (AL), and thinner choroid. Thus, myopia control therapies should be implemented early to avoid the development of high myopia, as the early age of myopia onset plays a fundamental role in myopia progression, with about 50% of children with myopia onset at 7 or 8 years of age developing high myopia in adulthood, if left untreated. Increased prevalence of high myopia related to AL elongation is likely to result in higher rates of myopic macular degeneration (MMD). At present, we do not know if treating myopic progression will avoid the development of MMD. However, it seems logical to slow AL elongation to prevent severe disease and complications associated with pathologic myopia. Consequently, controlling myopia progression has become one of the highest priorities for eye care professionals all over the world.
- Will the new anti-myopia spectacles be the standard of care in future?Publication . Lança, Carla; Pan, Chen-Wei; Grzybowski, AndrzejReports of myopia increases across the world show an expanding growing public health problem. Myopia prevalence is exceptionally high in some continents, especially in Asia, particularly East Asian countries, but was also reported to have increased in other continents, such as North America and Europe, although there is considerable variation between geographic areas and racial groups in the myopia burden. The presence of myopia, especially high myopia increases the risk of development of pathological myopia and visual impairment. The peak incidence of myopia occurs in childhood, but the associated blinding ocular complications develop later during adulthood. Children with an increased risk of visual impairment due to pathologic myopia often have a longer duration of the disease, longer axial length (AL), and thinner choroid. Thus, myopia control therapies should be implemented early to avoid the development of high myopia as early-age of myopia onset plays a fundamental role in myopia progression with about 50% of children with myopia onset at 7 or 8 years of age developing high myopia in adulthood, if left untreated. Increased prevalence of high myopia related to AL elongation is likely to result in higher rates of myopic macular degeneration (MMD). At present, we do not know if treating myopic progression will avoid the development of MMD. However, it seems logical to slow AL elongation to prevent severe disease and complications associated with pathologic myopia. Consequently, controlling myopia progression has become one of the highest priorities for eye care professionals all over the world.
- Lower indoor spatial frequency increases the risk of myopia in childrenPublication . Li, Dan-Lin; Dong, Xing-Xuan; Yang, Jin-Liu-Xing; Lança, Carla; Grzybowski, Andrzej; Pan, Chen-WeiBackground/aims: Animal models have shown that the absence of high-frequency visual information can precipitate the onset of myopia, but this relationship remains unclear in humans. This study aims to explore the association between the spatial frequency content of the visual environment and myopia in children. Methods: Images from the rooms of children and their frequently visited outdoor areas were taken by their parents and collected by the researcher through questionnaires. The spatial frequency was quantified using Matlab. Cycloplegic refraction was used to measure the spherical equivalent (SE), and IOL Master was used to measure axial length (AL) and corneal radius (CR). AL/CR ratio was calculated. Results: The study included 566 children with an average age of (8.04±1.47) years, of which 270 were girls (47.7%), and the average SE was (0.70±1.21) D. Image analysis revealed that indoor spatial frequency slope was lower than that of the outdoor environment (-1.43±0.18 vs -1.11±0.23, p<0.001). There were 79 myopic individuals (14.0%). Images from indoor content of myopic children had a lower spatial frequency slope than non-myopic children (-1.47±0.16 vs 1.43±0.18, p=0.03) while there was no significant difference in outdoor spatial frequency slope. Regression analysis indicated that the indoor spatial frequency slope was positively associated with SE value (β=0.60, p=0.02) and inversely related to myopia (OR=0.24, p<0.05). Conclusion: The spatial frequency of the outdoor environment is significantly higher than that of the indoor environment. Indoor spatial frequency is related to children's refractive status, with lower indoor spatial frequency being associated with a higher degree of myopia.
- Spatial frequency of environments and myopia: a systematic review on associated evidence and underlying mechanismsPublication . Li, Dan-Li; Lança, Carla; Zhang, Xiu-Juan; Grzybowski, Andrzej; He, Xian-Gui; Pan, Chen-WeiPurpose: Previous animal studies have found a relationship between spatial frequency and myopia. New research in humans suggests that reduced high spatial content of the visual environment may be a contributing factor to myopia development. This study aims to review the literature and elucidate the potential biological mechanisms linking spatial frequency and myopia. Methods: A systematic search was conducted across PubMed and Web of Science databases. The studies published from their inception to August 2024 have explored the connection between spatial frequency and myopia. Only full-text articles in English were included. PRISMA was used for data validity. Results: A total of 13 articles were included in this review, comprising seven animal model studies, four population-based studies, one pictorial analysis, and one study on research design. Epidemiological evidence is comparatively limited and has only begun to emerge in recent years. Mid- to high spatial frequencies were found to play an important role in the emmetropization process of the eye. Low spatial frequencies can increase the risk of myopia incidence. Furthermore, the potential mechanisms of how spatial frequency affects myopia are summarized as visual information processing characteristics, eye accommodation function, eye movements, contrast sensitivity, and relevant molecules involved in the pathway. Conclusion: The evidence suggests that indoor spatial frequency may be related to the development of myopia. Further studies are warranted to understand if the incorporation of changes in indoor environments is helpful in the prevention and control of myopia.